Conners CBRS Self-Report Assessment Report

By C. Keith Conners, Ph.D. Conners CBRS Self-Report Assessment Report Caution: The youth s reported age is out of the age range (6 18 years). T-scores were computed based on 17 18-year-old age norms; consequently, results presented in this report could be invalid. Any interpretation based on this report should be made with extreme caution. This Assessment report is intended for use by qualified assessors only, and is not to be shown or presented to the respondent or any other unqualified individuals. P.O. Box 950, North Tonawanda, NY 14120-0950 3770 Victoria Park Ave., Toronto, ON M2H 3M6

Introduction Conners Comprehensive Behavior Scale Self-Report (Conners CBRS SR) is an assessment tool that prompts the youth to provide valuable information about herself. This instrument is helpful when information regarding a number of childhood disorders and problem behaviors is required. When used in combination with other information, results from the Conners CBRS SR can provide valuable information to guide assessment decisions. This report provides information about the youth s score, how she compares to other youth, and which scales are elevated. See the Conners CBRS Manual (published by MHS) for more information. This computerized report is an interpretive aid and should not be given to clients or used as the sole criterion for clinical diagnosis or intervention. Administrators are cautioned against drawing unsupported interpretations. Combining information from this with information gathered from other psychometric measures, as well as from interviews and discussions with the youth, will give the practitioner or service provider a more comprehensive view of the youth than might be obtained from any one source. This report is based on an algorithm that produces the most common interpretations for the scores that have been obtained. Administrators should review the client s responses to specific items to ensure that these typical interpretations apply. Assessment of Validity The following section provides Danielle s scores for the Positive and Negative Impression scales and the Inconsistency Index. Positive Impression Raw score = 0 (Probably valid) The Positive Impression score does not suggest an overly positive response style. Negative Impression Raw score = 2 (Probably valid) The Negative Impression score does not suggest an overly negative response style. Inconsistency Index Raw score = 10, Number of absolute differences 2 = 3 (Probably invalid) The responses to similar items are quite different from one another. Inconsistent responding may produce invalid scores. Interpretation should focus on understanding the reasons for differences in responses to similar items. Page 2

Conners CBRS SR Content Scales: T-scores The following graph provides T-scores for each of the Conners CBRS SR Content scales and subscales. Page 3

Conners CBRS SR Content Scales: Detailed Scores The following table summarizes the results of Danielle s self assessment and provides general information about how she compares to the normative group. Please refer to the Conners CBRS Manual for more information on the interpretation of these results. Caution: please note that T-score cutoffs are guidelines only and may vary depending on the context of assessment. T-scores from 57 63 should be considered borderline and of special note since the assessor must decide (based on other information and knowledge of the youth) whether or not the concerns in the associated area warrant clinical intervention. Scale Emotional Distress Aggressive Behaviors Academic Difficulties Hyperactivity/ Impulsivity Separation Fears Raw T-score Score 77 76 67 25 24 17 Violence Potential 58 Physical Symptoms 24* 130 78 92 103 104 78 Guideline Very Elevated Score (Many more concerns than are typically reported) Very Elevated Score (Many more concerns than are typically reported) Very Elevated Score (Many more concerns than are typically reported) Very Elevated Score (Many more concerns than are typically reported) Very Elevated Score (Many more concerns than are typically reported) Very Elevated Score (Many more concerns than are typically reported) Very Elevated Score (Many more concerns than are typically reported) *Raw score(s) are based on extrapolated data due to omitted item(s). Common Characteristics of High Scorers Worries a lot (including possible social anxieties); may feel nervous. Low self-confidence. May show signs of depression. May have physical complaints (aches, pains, difficulty sleeping); may have repetitive thoughts or actions. Physically and/or verbally aggressive; may show violence, bullying, destructive tendencies; may be argumentative; may have poor control of anger/aggression. May seem uncaring. May have legal problems. Struggles with reading, writing, spelling, and/or arithmetic. May have difficulty keeping up in school. High activity levels, may be restless, may have difficulty being quiet. May have problems with impulse control; may interrupt others or have difficulty waiting for his/her turn. Fears being separated from parents/caregivers. At risk for acting violently. May complain about aches, pains, or feeling sick. May have sleeping or eating issues. Page 4

DSM-IV-TR Overview This section of the report provides the following information for each DSM-IV-TR diagnosis on the Conners CBRS SR: 1. DSM-IV-TR Symptom scales: T-scores 2. DSM-IV-TR Symptom scales: Detailed Scores 3. DSM-IV-TR Total Symptom Counts 4. DSM-IV-TR Symptom Tables Listing of Conners CBRS SR item(s) that correspond to each DSM-IV-TR Symptom Criterion status of each DSM-IV-TR Symptom (i.e, whether or not the symptom is "indicated," "may be indicated," or "not indicated"). Symptoms marked indicated or may be indicated are summed to get the Total Symptom Count for that diagnosis. Please refer to specific DSM-IV-TR Symptom tables for each criterion status and for exceptions that may alter the Total Symptom Count. See the Conners CBRS Manual for details on how each criterion status is determined. Interpretive Considerations Results from the Conners CBRS SR are a useful component of DSM-IV-TR based diagnosis, but cannot be relied upon in isolation. When interpreting the Conners CBRS SR DSM-IV-TR Symptom scales, the assessor should take the following important considerations into account. Please refer to the Conners CBRS Manual for further interpretative guidelines. The Conners CBRS SR contains symptom-level criteria, not full diagnostic criteria for DSM-IV-TR diagnosis. Additional criteria (e.g., course, age of onset, differential diagnosis, level of impairment, pervasiveness) must be met before a DSM-IV-TR diagnosis can be assigned. The Conners CBRS SR items are approximations of the DSM-IV-TR symptoms that are intended to represent the main clinical construct in a format that most youth can understand. As a result, some aspects of the DSM-IV-TR criteria may not be fully represented. Before using any diagnostic labels, the assessor must consider all criteria that are required for DSM-IV-TR diagnosis, including the symptoms from the Conners CBRS SR. The Conners CBRS SR provides information relevant to the DSM-IV-TR diagnoses from two different perspectives: absolute (Symptom Count) and relative (T-score). Results of the DSM-IV-TR Symptom Counts can contribute to consideration of whether a particular DSM-IV-TR diagnosis might be appropriate. A T-score for each DSM-IV-TR diagnosis facilitates comparison of this individual's symptoms with his or her peers. At times there may be discrepancies between the Symptom Count and T-score for a given diagnosis. This is to be expected, given that they are based on different metrics (i.e., absolute versus relative). The following points provide some concrete guidelines for interpretation of this pair of scores (DSM-IV-TR Symptom Count and T-score). Both scores are elevated (i.e., DSM-IV-TR Symptom Count probably met, DSM-IV-TR T- score ³ 60): This diagnosis should be given strong consideration. Both scores are or below (i.e., DSM-IV-TR Symptom Count probably not met, DSM-IV-TR T-score < 60): It is unlikely that the diagnosis is currently present (although criteria may have been met in the past). Only Symptom Count is elevated (i.e., DSM-IV-TR Symptom Count probably met, DSM- IV-TR T-score < 60): Although the absolute DSM-IV-TR symptomatic criteria may have been met, the current presentation is not atypical for this age and gender. Consider whether the symptoms are present in excess of developmental expectations (an important requirement of DSM-IV-TR diagnosis). Only T-score is elevated (i.e., DSM-IV-TR Symptom Count probably not met, DSM-IV-TR T-score ³ 60): Although the current presentation is atypical for the youth's age and gender, there are not sufficient symptoms reported to meet DSM-IV-TR symptomatic criteria for this disorder. Consider alternative explanations for why the T-scores could be elevated in the absence of this diagnosis (e.g., another diagnosis may be producing these types of concerns in that particular setting). Page 5

DSM-IV-TR Symptom Scales: T-scores The following graph provides T-scores for each of the DSM-IV-TR Symptom scales. Page 6

DSM-IV-TR Symptom Scales: Detailed Scores The following table summarizes the results of Danielle self assessment with respect to the DSM-IV-TR Symptom scales, and provides general information about how she compares to the normative group. Please refer to the Conners CBRS Manual for more information on the interpretation of these results. Caution: please note that T-score cutoffs are guidelines only and may vary depending on the context of assessment. T-scores from 57 63 should be considered borderline and of special note since the assessor must decide (based on other information and knowledge of the youth) whether or not the concerns in the associated area warrant clinical intervention. Scale Raw T-score Score Guideline ADHD Predominantly Inattentive Type 18 66 Elevated Score (More concerns than are typically reported) ADHD Predominantly Hyperactive-Impulsive Type 24 93 Very Elevated Score (Many more concerns than are typically reported) Conduct Disorder 33 165 Very Elevated Score (Many more concerns than are typically reported) Oppositional Defiant Disorder 15 72 Very Elevated Score (Many more concerns than are typically reported) Major Depressive Episode 30* 82 Very Elevated Score (Many more concerns than are typically reported) Manic Episode 18 81 Very Elevated Score (Many more concerns than are typically reported) Generalized Anxiety Disorder 29 77 Very Elevated Score (Many more concerns than are typically reported) Separation Anxiety Disorder 20 90 Very Elevated Score (Many more concerns than are typically reported) Social Phobia 10 70 Very Elevated Score (Many more concerns than are typically reported) Obsessive-Compulsive Disorder 12 74 Very Elevated Score (Many more concerns than are typically reported) *Raw score(s) are based on extrapolated data due to omitted item(s). Page 7

DSM-IV-TR Total Symptom Counts The following tables summarize the results of the DSM-IV-TR Total Symptom Counts as indicated by the Conners CBRS SR. Results from the Conners CBRS SR suggest that the Symptom Count requirements are probably met for the following DSM-IV-TR diagnoses: Scale ADHD Predominantly Hyperactive-Impulsive Type (ADHD Hyp-Imp) DSM-IV-TR Symptom Count Requirements At least 6 out of 9 symptoms Symptom Count as indicated by Conners CBRS SR 8 Conduct Disorder At least 3 out of 15 symptoms 14 Oppositional Defiant Disorder At least 4 out of 8 symptoms 5 Major Depressive Episode At least 5 out of 9 symptoms including A1 or A2 7 (A1: included; A2: not included) Manic Episode Criterion A Elevated Mood and at least 3 out of 7 Criterion B symptoms Criterion A Irritable Mood and at least 4 out of 7 Criterion B symptoms Criterion A: Elevated mood or Irritable mood Indicated Criterion B: 5 Mixed Episode Generalized Anxiety Disorder Criteria must be met for both Major Depressive Episode and Manic Episode Criteria A and B; At least 1 out of 6 Criterion C symptoms Major Depressive Episode: 7 (A1: included; A2: not included) Manic Episode: Criterion A: Elevated mood or Irritable mood Indicated Criterion B: 5 Criterion A: Indicated Criterion B: Indicated Criterion C: 6 7 Obsessions: 4 Compulsions: 0 Separation Anxiety Disorder At least 3 out of 8 symptoms Obsessive-Compulsive All 4 Obsessions symptoms Disorder Both Compulsions symptoms The Conners CBRS SR Symptom Count for Generalized Anxiety Disorder is based on the criteria for children. The Conners CBRS SR does not assess Criterion A7 (i.e., forced sexual activity) due to the sensitive nature of this criterion. At least one item was omitted from this scale. Results from the Conners CBRS SR suggest that the Symptom Count requirements are probably not met for the following DSM-IV-TR diagnoses: Scale ADHD Predominantly Inattentive Type (ADHD In) ADHD Combined Type Social Phobia DSM-IV-TR Symptom Count Requirements At least 6 out of 9 symptoms Symptom Count as indicated by Conners CBRS SR 5 Criteria must be met for both ADHD In and ADHD ADHD In: 5 Hyp-Imp ADHD Hyp-Imp: 8 Criteria A, B, and D Criterion A: Not Indicated (Note: Criterion C is not required for children) Criterion B: May be Indicated Criterion C: Indicated Criterion D: Indicated Page 8

DSM-IV-TR Symptom Tables This section of the report provides information about how Danielle rated items that correspond to the DSM- IV-TR. Please see the DSM-IV-TR Overview section for important information regarding appropriate use of DSM-IV-TR Symptom Counts. The following response key applies to all of the tables in this section. : 0 = Not true at all (Never, Seldom); 1 = Just a little true (Occasionally); 2 = Pretty much true (Often, Quite a bit); 3 = Very much true (Very often, Very frequently);? = Omitted item. DSM-IV-TR ADHD Predominantly Inattentive Type DSM-IV-TR Symptoms: Criterion A Item Number 0 1 2 3? Criterion Status 81 Indicated A1a. 37 A1b. 101 Not Indicated A1c. 9 Not Indicated 129 Indicated A1d. -and- 103 A1e. 32 Indicated A1f. 28 May be Indicated A1g. 116 Indicated A1h. 65 Not Indicated A1i. 154 Not Indicated DSM-IV-TR ADHD Predominantly Hyperactive-Impulsive Type DSM-IV-TR Symptoms: Criterion A Hyperactivity Item Number DSM-IV-TR ADHD Combined Type 0 1 2 3? Criterion Status A2a. 51 May be Indicated A2b. 110 Indicated 114 Indicated A2c. 86 A2d. 82 Indicated 29 Indicated A2e. 71 A2f. 76 Indicated Impulsivity A2g. 25 Not Indicated A2h. 99 Indicated A2i. 17 Indicated An ADHD Combined Type diagnosis requires the examination of symptoms for ADHD Predominantly Inattentive Type and for ADHD Predominantly Hyperactive-Impulsive Type. See the ADHD Predominantly Inattentive Type and ADHD Predominantly Hyperactive-Impulsive Type symptom tables above. Please also see the DSM-IV-TR or the Conners CBRS Manual for additional guidance. Page 9

DSM-IV-TR Conduct Disorder DSM-IV-TR Symptoms: Criterion A Item Criterion Status Number 0 1 2 3? A1. 6 Indicated A2. 85 Indicated A3. 170 Indicated A4. 144 Indicated A5. 112 Indicated A6. 60 Indicated A8. 62 Indicated¹ A9. 48 Indicated¹ A10. 87 Indicated A11. 96 Indicated A12. 43 Indicated A13. 162 Indicated² A14 64 Indicated A15. 67 Indicated³ ¹Both Criterion A8 (fire setting) and Criterion A9 (destruction of property) were indicated. In order to meet Criterion A9, the assessor must confirm that property was destroyed other than by fire-setting (Criterion A8). ²In order for Criterion A13 (stays out at night) to be indicated the assessor needs to ensure this criterion occurred before the age of 13 years. ³In order for Criterion A15 (truancy) to be indicated the assessor needs to ensure this criterion occurred before the age of 13 years. Note: The Conners CBRS SR does not assess Criterion A7 (i.e., forced sexual activity) due to the sensitive nature of this criterion. DSM-IV-TR Oppositional Defiant Disorder DSM-IV-TR Symptoms: Criterion A Item Criterion Status Number 0 1 2 3? A1. 58 May be Indicated A2. 117 Not Indicated A3. 33R Not Indicated A4. 134 Not Indicated A5. 88 Indicated A6. 148 Indicated A7. 143 Indicated A8. 20 Indicated R = This item is reverse scored for score calculations. Page 10

DSM-IV-TR Major Depressive Episode DSM-IV-TR Symptoms: Criterion A Item Criterion Status Number 0 1 2 3? A1. 115 May be Indicated A2. 93 Not Indicated A3. 8? A4. 125 70 158 1 ¹Investigation by the assessor is to determine whether tiredness or low energy represents a change from typical energy levels (for Criterion A6). ²In order to fully assess Criterion A9, follow-up is to determine if there have been recurrent thoughts of death or suicide, if a suicide plan has been made, or if there has been a suicide attempt. Notes: When considering DSM-IV-TR symptom criteria for Major Depressive Episode, the assessor needs to ensure the youth experiences these symptoms nearly every day. Presence of absence of a Major Depressive Episode is one important component of DSM-IV-TR diagnoses such as Major Depressive Disorder, Bipolar Disorder I, or Bipolar Disorder II. Please see the DSM-IV-TR for further guidance regarding these diagnoses. Indicated May be Indicated 86 A5. 26 A6. 137 Indicated¹ A7. 118 135 Indicated Indicated 12 A8. 147 A9. 146 Indicated²? = Item(s) were omitted and the criterion status cannot be determined. Page 11

DSM-IV-TR Manic Episode DSM-IV-TR Symptoms: Item Criterion Status Criteria A and B Number 0 1 2 3? A: Elevated or Irritable Mood 89 Indicated¹ B1. 171 Indicated B2. 108 Not Indicated B3. 63 Indicated B4. 27 Indicated B5. 126 Indicated 149 Indicated B6. 86 B7. 166 Not Indicated ¹Follow-up is required to determine whether Danielle s mood is elevated, expansive, or irritable. Note: Presence or absence of a Manic Episode is one important component of DSM-IV-TR diagnoses such as Bipolar I Disorder. Please see the DSM-IV-TR for further guidance regarding this diagnosis. DSM-IV-TR Mixed Episode Identifying a Mixed Episode requires the examination of symptoms for both Major Depressive Episode and Manic Episode. Please see the Major Depressive Episode and Manic Episode symptom tables above. Please also see the DSM-IV-TR for additional guidance. Page 12

DSM-IV-TR Generalized Anxiety Disorder DSM-IV-TR Symptoms: Item Criterion Status Criteria A, B and C Number 0 1 2 3? A. 78 Indicated B. 38 Indicated 3 Indicated C1. 86 137 Indicated C2. 35 C3. 113 Indicated C4. 142 Indicated C5. 13 Indicated C6. 10 1 70 158 DSM-IV-TR Separation Anxiety Disorder Indicated DSM-IV-TR Symptoms: Criterion A Item Criterion Status Number 0 1 2 3? A1. 61 Indicated A2. 24 Not Indicated A3. 145 Indicated A4. 151 Indicated 14 Indicated A5. 140 A6. 127 Indicated A7. 49 Indicated A8. 52 Indicated Page 13

DSM-IV-TR Social Phobia DSM-IV-TR Symptoms: Criteria A, B, C and D A. Item Number 44 -and- 23R Note: Criterion C (i.e., insight) is not required for children. 0 1 2 3? Criterion Status Not Indicated B. 46 May be Indicated C. 5 Indicated 74 D. 84 R = This item is reverse scored for score calculations. DSM-IV-TR Obsessive-Compulsive Disorder DSM-IV-TR Symptoms: Criterion A Criteria A, B, C and D Obsessions Item Number 0 1 2 3? Indicated Criterion Status A1. 94 Indicated A2. 2 Indicated A3. 22 Indicated A4. 31 Indicated Compulsions A5. 54 Not Indicated A6. 119 Not Indicated Page 14

Impairment Danielle s report of her level of impairment in academic, social, and home settings is presented below. Academic Not true at all/never Just a little true/occasionally Pretty much true/often Danielle indicated that her problems seriously affect her schoolwork or grades often (score of 2). Social Very much true/very often Danielle indicated that her problems seriously affect her friendships and relationships very often or very frequently (score of 3). Home Danielle indicated that her problems seriously affect her home life occasionally (score of 1). Conners Clinical Index The following graph presents the Conners Clinical Index score that was calculated from Danielle's ratings. The Conners Clinical Index score is calculated from 24 items that were statistically selected as the best items for distinguishing youth with a clinical diagnosis (including Disruptive Behavior Disorders, Learning and Language Disorders, Mood Disorders, Anxiety Disorders, and ADHD) from youth in the general population. Among clinical and general population cases, individuals with a clinical diagnosis obtained this score 96% of the time. Based on this metric, a clinical classification is strongly indicated, but other clinically relevant information should also be carefully considered in the assessment process. Please see the Conners CBRS Manual for further information about interpretation. Page 15

Other Clinical Indicators The following table displays the results from Danielle s ratings of her behavior with regard to specific items that are related to other clinical concerns or diagnoses. Endorsement of these items may indicate the need for further investigation. Item Item Content Number 6 73 109 138 150 90R 152 160R Bullying Perpetration Bullying Victimization Panic Attack: dizziness Panic Attack: feels sick Panic Attack: shortness of breath PDD: inflexibility PDD: problems with peer relations PDD: social or emotional reciprocity 0 1 2 3? Recommendation Further investigation is Further investigation is Further investigation is No need for further investigation is indicated 98 Pica Further investigation is 55 PTSD: traumatic event involving self Further investigation is 139 PTSD: traumatic event involving others 59 Specific Phobia Further investigation is 168 Substance Use: alcohol Further investigation is 68 Substance Use: illicit drugs Further investigation is 141 Substance Use: inhalants Further investigation is 105 Substance Use: tobacco Further investigation is 95 Tics: motor Further investigation is 21 Tics: vocal Further investigation is 124 Trichotillomania Further investigation is : 0 = Not true at all (Never, Seldom); 1 = Just a little true (Occasionally); 2 = Pretty much true (Often, Quite a bit); 3 = Very much true (Very often, Very frequently);? = Omitted item. R = This item is reverse scored for score calculations. Page 16

Self-Harm Critical Items The following table displays Danielle s ratings of her behavior with regard to several Self-Harm Critical Items. Endorsement of any Critical item indicates the need for immediate follow-up. Item Item Content Number 146 167 97 72 16 135 Self-Harm Discouraged Nobody cares Helplessness Hopelessness Worthlessness 0 1 2 3? Recommendation : 0 = Not true at all (Never, Seldom); 1 = Just a little true (Occasionally); 2 = Pretty much true (Often, Quite a bit); 3 = Very much true (Very often, Very frequently);? = Omitted item. Severe Conduct Critical Items The following table displays Danielle s ratings of her behavior with regard to several Severe Conduct Critical Items. Endorsement of any Critical item indicates the need for immediate follow-up. Item Item Content Number 0 1 2 3? Recommendation 170 Uses a weapon 56 Carries a weapon 36 Knows where to get a weapon 112 Cruel to animals 60 Confrontational stealing 62 Fire setting 87 Breaking and entering 136 Gang membership : 0 = Not true at all (Never, Seldom); 1 = Just a little true (Occasionally); 2 = Pretty much true (Often, Quite a bit); 3 = Very much true (Very often, Very frequently);? = Omitted item. Additional Questions The following section displays additional comments that Danielle has about herself. Item Item Content Number 178 Additional problems 179 Strengths or skills This item was omitted. This item was omitted. Page 17

Conners CBRS SR Results and IDEA The Conners CBRS SR provides information that may be useful to consider when determining whether a student is eligible for special education and related services under current U.S. federal statutes, such as the Individuals with Disabilities Education Improvement Act of 2004 (IDEA 2004). Elevated scores on the Conners CBRS SR may indicate the need for special education and related services. The following table summarizes areas of IDEA 2004 eligibility that are typically listed for children and adolescents who have elevated scores on various portions of the Conners CBRS SR. Checkmarks indicate which areas of the Conners CBRS SR were indicated or endorsed, suggesting possible consideration of IDEA 2004 eligibility in related areas. The information in this table is based on the IDEA 2004 and general interpretation/application of this federal law. Specific state and local education agencies may have specific requirements that supersede these recommendations. The assessor is encouraged to consult local policies that may impact decision making. Remember that elevated scores or even a diagnosis is not sufficient justification for IDEA 2004 eligibility. Finally, keep in mind that the IDEA 2004 clearly indicates that categorization is not required for provision of services. Please see the Conners CBRS Manual for further discussion of the IDEA 2004 and its relation to the Conners CBRS SR content. Content Areas Conners CBRS SR Content Scales Emotional Distress Aggressive Behaviors Academic Difficulties Hyperactivity/Impulsivity Separation Fears Violence Potential Physical Symptoms DSM-IV-TR Symptom Scales Follow-up Recommended Possible IDEA Eligibility Category DD-Emotional, DD-Emotional, DD-Communication, LD, S/L DD-Emotional,, OHI DD-Emotional, DD-Emotional, DD-Emotional,, OHI ADHD Predominantly Inattentive Type, LD, OHI ADHD Predominantly Hyperactive-Impulsive Type, OHI ADHD Combined Type, LD, OHI Conduct Disorder Oppositional Defiant Disorder Major Depressive Episode Manic Episode Mixed Episode Generalized Anxiety Disorder Separation Anxiety Disorder Social Phobia Obsessive-Compulsive Disorder Autism, DD = Developmental Delay, = Emotional Disturbance, LD = Specific Learning Disability; OHI = Other Health Impairment; S/L = Speech or Language Impairment Note: The category of Developmental Delay applies only to children through age 9 years. Page 18

Content Areas Other Clinical Indicators Bullying Perpetration Bullying Victimization Panic Attack Pervasive Developmental Disorder Pica Posttraumatic Stress Disorder Specific Phobia Substance Use Tics Trichotillomania Critical Items Follow-up Recommended Possible IDEA Eligibility Category DD-Emotional, DD-Social, DD-Emotional, DD-Social, Autism Autism,, OHI Self-Harm DD-Emotional, Severe Conduct DD = Developmental Delay, = Emotional Disturbance, LD = Specific Learning Disability; OHI = Other Health Impairment; S/L = Speech or Language Impairment Note: The category of Developmental Delay applies only to children through age 9 years. OHI Page 19

Item Responses Danielle entered the following response values for the items on the Conners CBRS SR. Response key: 0 = In the past month, this was not true at all. It never (or seldom) happened. 1 = In the past month, this was just a little true. It happened occasionally. 2 = In the past month, this was pretty much true. It happened often (or quite a bit). 3 = In the past month, this was very much true. It happened very often (very frequently).? = Omitted Item Date printed: June 16, 2008 End of Report Page 20

Conners Comprehensive Behavior Scales Feedback Handout for Self-Report s Child's Name: Child's Age: Date of Assessment: Assessor's Name: Danielle 19 January 05, 2008 Allen This feedback handout explains scores from ratings of this youth s behaviors and feelings as assessed by the Conners CBRS Self-Report Form (Conners CBRS SR). This section of the report may be given to parents (caregivers) or to a third party upon parental consent. What is the Conners CBRS? The Conners CBRS is a set of rating scales that are used to gather information about the behaviors and feelings of children and adolescents. These rating scales can be completed by parents, teachers, and youth. The Conners forms were developed by Dr. Conners, an expert in child and adolescent behavior, and are used all over the world to assess youth from many cultures. Research has shown that the Conners scales are reliable and valid, which means that you can trust the scores that are produced by the youth s ratings. Why do youth complete the Conners CBRS? Information from the youth about his or her own behavior and feelings is extremely important, as the youth knows how he or she feels better than anyone else. Self-reports provide invaluable information about the youth s own perceptions, feelings, and attitudes about his or her behavior that parents and teachers may not be aware of. Unlike parent and teacher ratings which provide information about either home or school settings, youth are able to give information about their feelings and behaviors across settings and situations. They know how they feel and behave all of the time. The most common reason for using the Conners CBRS scales is to better understand a youth who is having difficulty, and to determine how to help. The Conners CBRS scales can also be used to make sure that treatment services are helping, or to see if the youth is improving. Sometimes the Conners CBRS scales are used for a routine check, even if there is no reason to suspect the youth is struggling with a problem. If you are not sure why the youth was asked to complete the Conners CBRS, please ask the assessor listed at the top of this feedback form. How does the Conners CBRS work? Danielle read 179 items, and decided how well each statement described herself, or how often each behavior happened in the past month ( not at all/never, just a little true/occasionally, pretty much true/often, or very much true/very frequently ). Danielle s responses to these 179 statements were combined into several groups of items. Each group of items describes a certain type of behavior (for example, problems with mood or anxiety). Danielle s responses were compared with what is expected for 17-18-year-old girls. The scores for each group of items showl how similar Danielle is to her peers. This information helps the assessor know if Danielle is having more difficulty in a certain area than other 17-18- year-old girls. Results from the Conners CBRS Self Form The assessor who asked Danielle to complete the Conners CBRS will help explain these results and answer any questions you might have. Remember, these scores were calculated from how Danielle described herself in the past month. The self-report ratings help the assessor know how Danielle acts at home, school, and in the community. The results from the self-report ratings on the Conners CBRS should be combined with other important information, such as interviews with Danielle and her parent, other test results, and observations of Danielle. All of the combined information is used to determine if Danielle needs help in a certain area and what kind of help is needed. As you go through the results, it is very helpful to share any additional insights that you might have, make notes, and freely discuss the results with the assessor. If the scores do not make sense to you, you should let the assessor know so that you can discuss other possible explanations. Page 1

Danielle s responses to the 179 items were combined into groups of possible problem areas. The following table lists the main topic areas covered by the Conners CBRS Self-Report form. These scores were compared with other 17-18-year-old girls. This gives you information about whether Danielle described typical or levels of concern (that is, not an area of concern ) or if she described more concerns than for 17-18-year-old girls. The table also gives you a short description of the types of difficulties that are included in each possible problem area. Danielle may not show all of the problems in an area; it is possible to have more concerns than even if only some of the problems are happening. Also, it is possible that Danielle may describe typical or levels of concern even when she is showing some of the problems in an area. It is important to discuss these results with the assessor listed at the top of this feedback handout. This feedback handout describes results only from the Conners CBRS Self-Report form. A checkmark in the more concerns than box does not necessarily mean that Danielle has a serious problem and is in need of treatment. Conners CBRS results must be combined with information from other sources and be confirmed by a qualified clinician before a conclusion is made that an actual problem exists. Academic Difficulties Not an area of concern (good/ score) In Not an area of concern (good/ score) Hyperactivity/Impulsivity Not an area of concern (good/ score) More concerns than (elevated score) More concerns than (elevated score) More concerns than (elevated score) Problems that may exist if there are more concerns than Struggles with reading, writing, spelling, and/or math; difficulty keeping up in school. Problems that may exist if there are more concerns than Problems with concentration, to details, or staying focused; needs reminders; poor organizational skills and/or listening skills; difficulty remembering. Problems that may exist if there are more concerns than High activity levels; restless; difficulty being quiet; poor impulse control (interrupts others, difficulty waiting for his/her turn). Oppositional and Aggressive Behavior Not an area of concern (good/ score) More concerns than (elevated score) Problems that may exist if there are more concerns than Physical/verbal aggression; violent/destructive behaviors; poor anger control; bullying, argumentative. Behaviors that suggest he/she may be violent in the future, if not already violent. Aggression; cruelty; destruction of property; deceitfulness; theft; serious rule-breaking behaviors. Oppositional, hostile, defiant behaviors. Problems with Mood Not an area of concern (good/ score) More concerns than (elevated score) Problems that may exist if there are more concerns than Symptoms of depression Mood swings; very high opinion of self; pleasure-seeking behaviors. Page 2

Problems with Anxiety Not an area of concern (good/ score) Emotional Distress Not an area of concern (good/ score) More concerns than (elevated score) More concerns than (elevated score) Problems that may exist if there are more concerns than Extreme worries that are difficult to control, physical signs of anxiety. Extreme worries about being separated from his/her family/caregivers; refusal to leave home, nightmares, physical signs of anxiety. Anxiety about social situations; worries about embarrassment; avoids doing things in front of other people. Thinks about certain things repetitively; even though they are upsetting; does certain behaviors repetitively. Problems that may exist if there are more concerns than Worrying; nervous; low self-confidence; symptoms of depression and/or physical complaints; gets stuck on certain ideas or behaviors. Physical Symptoms Not an area of concern (good/ score) More concerns than (elevated score) Problems that may exist if there are more concerns than Complains about aches, pains, or feeling sick; sleep, appetite, or weight issues. Validity Information about the validity of the Conners CBRS results should be considered when the assessor reviews the results with you. Additional Topics for Discussion In addition to the results described above, some of Danielle s responses on the Conners CBRS suggest it is important to consider the following topics in further evaluation. Please ask the assessor listed at the top of this form to discuss these areas with you. Bullying others Being the victim of bullying Symptoms of panic Eating non-food items (e.g., dirt) Exposure to a traumatic event Phobias Alcohol use Illicit drug use Tobacco use Use of inhalants Tics Pulling out own hair Behaviors associated with extreme misbehavior Behaviors, thoughts, and feelings associated with self-harm Features in common with youth who have a clinical diagnosis When asked to rate whether the problems described on the Conners CBRS Self-Report Form affected Danielle's functioning, she responded: Danielle indicated that her problems often seriously affect her schoolwork or grades. Danielle indicated that her problems very often seriously affect her friendships and relationships. Danielle indicated that her problems occasionally seriously affect her home life. Page 3

Assessor comments: Page 4